A Unified Approach of Cost-Effectiveness Analysis

成本效益分析的统一方法

• 批准号: 7777382
• 负责人: Heejung Bang
• 金额: $ 16.99万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2012-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7777382
• 关键词: Accounting; Address; Adopted; Attention; Caring; Complement; Computer software; Confidence Intervals; Consensus; Cost Effectiveness Analysis; Data; Data Set; Decision Making; Defibrillators; Economics; Expenditure; Health Sciences; Journals; Measures; Medical; Methodology; Methods; Outcome; Paper; Policies; Policy Maker; Procedures; PubMed; Public Health; Publications; Publishing; Recording of previous events; Relative (related person); Research Personnel; Resources; Societies; Statistical Methods; Stress; Uncertainty; Writing; base; cost; cost effectiveness; economic evaluation; implantation; simulation; social; tool; user friendly software

DESCRIPTION (provided by applicant): Our society is continually faced with difficult decisions when allocating resources and containing costs. Cost-effectiveness analysis (CEA) is an economic study that compares the relative expenditures and outcomes of multiple strategies for performing the same task. The use of CEA in various fields, including economic, social, biomedical, and public health sciences, has been popular for many years. [43,895 articles found in PubMed using "cost-effectiveness analysis"]. Statistical methods for CEA have been extensively developed, and some measures have been widely adopted. However, it is clear that CEA remains controversial despite its long history of use and the efforts that have been made to understand various aspects of it. [For example, more than 20 methodology papers have been published on one statistical problem: deriving or comparing confidence intervals for the incremental cost-effectiveness ratio. This level of attention and publication is highly unusual in other statistical problems/settings.] Moreover, many journals have written publication policies on CEA. This is primarily due to the fact that: 1) different methods for CEA can yield different, often counterintuitive or inconsistent results; 2) there is uncertainty and difficulty in interpreting the analysis that was performed; 3) there is a lack of consensus on methods; and 4) there is a huge impact that CEA may have on decision making. As such, most of the existing analyses require great caution and care before, during and even after the analysis. We claim that the current standard approach for CEA is suboptimal and can be problematic, as it is based on only one analytical perspective and does not account for some important methodological issues. In this proposal, we intend to address these aspects of CEA and to develop methodologies and computer software in a unified framework. We wish to stress that multiple analytic methods should be chosen and evaluated together before one makes a conclusive statement about the cost-effectiveness of different strategies. The proposed methods do not compete with one another but are complementary, because they fulfill different tasks and would collectively provide a more comprehensive perspective for economic evaluations.

描述（由申请人提供）：在分配资源并包含成本时，我们的社会不断面临艰难的决定。成本效益分析（CEA）是一项经济研究，比较了执行相同任务的多种策略的相对支出和结果。多年来，在包括经济，社会，生物医学和公共卫生科学在内的各个领域的CEA使用，包括经济，社会，生物医学和公共卫生科学。 [使用“成本效益分析”在PubMed中发现的43,895篇文章]。 CEA的统计方法已广泛开发，并且已经广泛采用了一些措施。但是，很明显，尽管CEA的使用历史悠久，并且已经努力理解了它的各个方面，但CEA仍然存在争议。 [例如，已经在一个统计问题上发表了20多篇方法论文：得出或比较增量成本效益比的置信区间。在其他统计问题/环境中，这种关注和出版的水平非常不同。这主要是由于以下事实：1）CEA的不同方法可以产生不同的，通常是违反直觉或不一致的结果； 2）解释执行的分析存在不确定性和困难； 3）关于方法缺乏共识； 4）CEA可能对决策产生巨大影响。因此，大多数现有分析都需要在分析之前，期间甚至之后都非常谨慎和关心。我们声称，当前的CEA标准方法是次优的，并且可能是有问题的，因为它仅基于一个分析的观点，并且没有考虑到一些重要的方法论问题。在此建议中，我们打算解决CEA的这些方面，并在统一框架中开发方法和计算机软件。我们希望强调，在对不同策略的成本效益作出结论性的陈述之前，应选择多种分析方法。所提出的方法并非彼此竞争，而是互补的，因为它们完成了不同的任务，并将共同为经济评估提供更全面的观点。